상부소환관협착에 대한 Savary-Gilliard Dilatation의 치료효과와 안전성에 관한 관찰

정현용,육은주,임의혁,김병호,성자원,이기천,허승식,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

For the patient with stenosis of upper digestive tract caused by either benign or malignant process, esophageal dilatation is an important therapeutic modality. We reviewed retrospectively 39 cases treated by Savary-Gilliard dilatation for upper digestive tract stenosis, and results were follows : (1) Dysphagia was improved in 95% of the patients. (2) Eight patients(20%) sufferd perforation, five of them were managed with conservative medical measures, others were managed operatively. (3) In the cases with benign stenosis dysphagia was not noticed for 8.8 months, but with malignant stenosis dysphagia was reappeared after 2.8 months despite concomitant chemoradiotherapy. In conclusion, Savary-Gilliard dilatation was an effective measure for symptome due to upper digestive tract stenosis, but more careful attention for perforation should be necessitated. Also another therapeutic modality for treatment of malignant stenosis was inevitable.

결장직장암 환자의 임상적 고찰 : 조선대학교 부속병원의 10년 간의 결과

나은종,문성표,장정환,김권천,민영돈,김성환,조현진,김정용,김경종 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: The colorectal cancer rates 4th in the total cancer prevalence in Korea. The clinical patient demographics were considered with the incidence rate of the colon and rectal cancer. The clinicopathological factors were analyzed for the 5 year survival rate. Materials Methods: Of the 282 patients who were operated from Jan. 1, 1992 to Dec. 31, 2001 and diagnosed by pathological biopsy as colo-rectal cancer, 234 patients were followed up. The age, sex, location of the cancer, TNM stage, operation method, histopathological classification, metastatic region, complications after operation and the survival rate were investigated. Results: Of the 234 patients, male and female consisted of 120 cases (51.3%) and 114 cases (46.7%), with an average age of 61.6 years. The average follow up period was 52.3 months and the peri operative mortality was 5.6%. The site of the cancer was most frequent at the rectum with 127 cases (54.3%). The patients were classified according to the TNM stages with 38 cases of stage 1 (16.2%), 98 cases of II (41.9%), 72 cases of III (30.8%) and 26 cases of IV (11.1%). The 5 year survival rate in the age group older than 50 was 63.3 % and 73.5% in the group younger than 50. In regard to the operation type, the 5 year survival rate was 65.4% for elective operation and 65.8% for emergency operation. The 5 year survival rate for well differentiated, moderately differentiated, poorly differentiated cancer, and mucinous adenocarcinoma was 73.7%, 60.2%, 58.3%, and 92.6%, respectively. The 5 year survival rate of each of the TNM stage is 81.1%, 74.8%, 57.0%, and 11.5% for Classes I, II, III, and IV, respectively. Conclusion: The clinical factors were analyzed for the 5 year survival rate with no statistical significance for the age, sex, and location of the cancer. The TNM stage and histopathological differentiation were statistically significant. The colon cancer showed better prognosis compared to the rectal cancer.

조기위암의 형태학적인 분류에 따른 임파절 전이 양상

최은서,강길,박정희,장정환,김권천,김경종,민영돈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Currently, in the limited cases of early gastric cancer (EGC), endoscopic mucosal resection (EMR) is used for curative treatment. However, its completeness is still controversial. The purpose of this study was to review the suggested indications of EMR. We retrospectively analyzed 234 patients with EGC who underwent curative (RO) gastrectomy. The enrolled cases were further classified into mucosal and submucosal types, and mucosal EGC were further classified according to the size, gross type and histologic pattern. 133 patients had mucosal cancers and 101 patients submucosal. The overall incidence of positive lymph node was 14.1% (33/234), the incidence of mucosal cancer was 8. 3% (11/133), which was significantly lower than that of submucosal, 22% (22/101). Of 133 patients with mucosal EGC, 90 were smaller than 2㎝ in size and the incidence of lymph node metastasis was 5.6% (5/90), compared to 43 of larger than 2㎝ with the incidence of 14% (6/43). According to the gross type classification of mucosal cancer, incidence of lymph node metastasis in protruded type (EGC type Ⅰ, Ⅱa, Ⅰ+Ⅱa) was 15.4% (4/26), nat type(EGC type Ⅱb) 2. 9% (1/35), depressed type (EGC type Ⅱc, Ⅲ) 8.3% (6/72). Lymph node metastasis in differentiated type of mucosal cancer was 6.9% (5/72) and undifferentiatcd type 9.8% (6/61). In this study, there was no single indication free from lymph node metastasis, It is thought that the selection of EMR for the curative treatment of EGC should be considered carefully and more clinical studies with long-term follow up are necessary for EMR to be generally acceptable.

(±)-Camphor가 ICR 마우스 수컷의 간 cytochrome P450 효소 활성에 미치는 영향

오은경,박형건,배기현,최옥진,최은경,최창근,한진희,정태천 한국환경독성학회 2002 환경독성보건학회지 Vol.17 No.4

Effects of (±)-camphor on liver cytochrome P450 enzymes were investigated in male ICR mice. Mice were treated intraperitoneally with 0, 200, 400 and 800 mg/kg of (±) -camphor in corn oil for 3 consecutive days. Twenty four hr after the final treatment, the animals were subjected to necropsy. The activities of serum aspartate aminotransferase and serum alanine aminotransferase were slightly changed by the treatment with (±)-camphor at the doses used. Administration o(±)-camphor to mice significantly induced the hepatic activities of pentoxyresorufin O-depentylase and benzyloxyresorufin O-debenzylase and weakly induced ethoxyresorufin O-deethylase in dose-dependent manners. The present results suggested that (±)-camphor might act as a relatively specific inducer of hepatic cytochrome P450 213 in male ICR mice.

피부 병변을 동반한 악성조직구증 1예

조은택,박용관,김진호,강정원,천영욱,전익섭,박유환,전춘해 조선대학교 1995 The Medical Journal of Chosun University Vol.20 No.1

Malignant histiocytosis, originally described in 1939 as histiocytic medullary reticulosis by Scott and Robb-Smith, is a rare histiocytic proliferative disorder that often shows an acute onset and used to progress to death within a few months. This disorder characterized clinically by fever, generalized weakness, lymphadenopathy and hepatosplenomegaly, and shows a variable range of pancytopenia. Extranodal involvement is common, with an incidence ranging from 50% to as high as 90%, skin involves8ment was noted in 10% to 15%. Typical skin lesions were mainly founded in extremity. i.e. erythematous papule and nodule occasionally become to necrosis and ulceration. We experienced one case of malignant histiocytosis in a 46-years-old female. The major clinical findings are fever, malaise, hepatosplenomegaly and erythematous skin lesion. In the laboratory study, pancytopenia is noted on the peripheral blood. And also aggregation of many atypical histiocytes were shown on skin and bone marrow biopsy. So we reported one related case with malignant histiocytosis as well as reviewing literature .

多樣한 黃芩藥鍼製劑의 安全性 및 效能에 關한 硏究

김호경,마진열,전원경,윤수영,강은정,주혜정,고병섭 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri(足三里) of rat, repeatedly. we compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days (p<0.05) and after 7 days (p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight: In Palking aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of hwanggum aqua-acupuncture (× 10 group) was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture (× 100 group), D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound (CPA group) and HG, there were significant value in statistically. The diluted solution was more significant decrease than Hwanggaum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupuncture tended to decrease level of TG, regardless of its concentration. In acupuncture group, we gained some interesting result in meaningful decrease in TG. 5. Haematological examination showed significant increment of gramulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

중미 국가의 노사관계 및 노동법제 연구 : 과테말라, 엘살바도르, 온두라스를 중심으로

이철수,박귀천,박은정 梨花女子大學校 法學硏究所 2003 法學論集 Vol.7 No.2

In these days, our labor-intensive industries in Korea such as fiber and sewing industries are being transferred to the overseas countries. In such a tendency, three countries in the Central America including Guatemala, the Public El Salvador and Honduras which are the subjects of this study provided the companies whose target is to export their goods to America, a motive to find a market in the Central America, because of the following factors: (ⅰ) being benefited by no tax pursuant to the Caribbean Sea district development plan; (ⅱ) a geographical condition of a neighboring country of USA, as well as (ⅲ) a factor of a country abundant in cheap labor force. Accordingly, the number of formal investments in their countries currently reached to 100 cases, and the Korean companies of various sizes have invested in these countries. However, actually, the information concerning the investment and the labor related laws for such countries are very insufficient. Therefore, the purpose of this study is to introduce the labor-management relationship and labor related laws of such countries. In case of the labor laws in Guatemala, the collective labor-management relations and individual labor relations are provided for in a law, and the characteristic of each law is as follows. In case of the collective labor-management relations, the administrative authority intervenes in the establishment of a labor union or the execution of the collective bargaining agreement. For the establishment of a labor union, the written consents of 20 or more employees are required. The establishment of multiple trade unions is permitted, but joining two or more union is not allowed. Union shop is not allowed, either. With respect to the collective bargaining, the bargaining bodies are unified in accordance with a job type, and general binding power in the local view of the collective bargaining has been introduced. They allow the right to strike to general workers. Unusually, they guarantee the wages during the labor disputes, so the principle of No Work, No Pay is not accepted. For the labor dispute, they have the system under which the labor court judges the lawfulness of the labor dispute in advance. Furthermore, it is provided for in the law that the labor dispute shall not be caused due to the issue related to the conflict for the rights. In order to go on a strike, the employees should go through the procedures of settlement-mediation-arbitration.. The law related to unfair labor practice does not exist. However, the employer shall not interfere the employees in joining or withdrawing from a labor union. Employers are prohibited from dismissing the employees for the reason of their participation in the establishment of a labor union. With respect to the individual labor-management relation, the administrative authority is expected to be participated in executing the employment agreement. The reasons for the just dismissal are also prescribed in the law. If an employer intends to dismiss an employee for a reason not provided for in the law, the employer shall pay the separation allowance, differentially in accordance with the consecutive years of service of the employee concerned. Besides, it is unusual that they have introduced the indirect dismissal system under which the employee may terminate his/her employment agreement in case where there occurs a reason attributable to the employer. They also guarantee the employees’ right for the paid leave, the annual leave and the minimum wage system like Korea. In case of Honduras and the Public El Salvador, their labor laws are similar to those of Guatemala in the view of basic contents thereof. However, there are some differences in the detailed contents. In Honduras, 30 employees are required for the establishment of a labor union, but in the Public El Salvador, 35 employees are required for the establishment of a labor union. With respect to the collective bargaining by the multiple trade union, in Honduras, they have the single-multiple delegate system, while in the Public El Salvador, they have the exclusive bargaining delegate system. Unlike Guatemala, Honduras and the Public El Salvador do not have the provision on the payment of wages during the labor disputes. In addition, the three countries are similar in the following aspects: (ⅰ) there practically exists the unfair labor practice; (ⅱ) they all provide for the reasons for just dismissal in the law; and (ⅲ) they all have introduced the indirect dismissal system. The countries intends to invest in the said three countries in the Central America is required to pay attention to the following. It is of course important to observe the labor laws of the country in which the companies intends to invest, and to avoid the unnecessary conflicts with the local employees. However, if the main purpose of their investment is to export their goods to USA, they need to understand that since the owner company of USA who places an order plays a role of labor inspector due to the power of influence of the citizen groups and human right groups of USA, the relationship with the American buyers and the maintenance of proper working environment to the degree requested by such buyers are important factors.

내시경으로 진단된 소화성 궤양의 임상적 고찰

김영건,육은주,김성걸,임의혁,성자원,김병호,허승식,이기천,정현용,이헌영 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

A clinical analysis was performed of 3055 pateints with peptic ulcer who were diagnosed with gastroduodenoscopy, in Hospital of Chungnam National University College of Medicine from July 1988 to May 1993. 1) During the period 1988-1993, The proportion of gastric ulcer among peptic ulcer decreased from 47.8% to 42.8%, but that of duodenal ulcer increased from 36.8% to 39.6%. 2) Of the 3055 cases, the number of patients with esophageal ulcer was 98(3.2%), with gastric ulcer 1407(41.6%), with. duodenal ulcer 1104(36.1%), with channel ulcer 149(4.9%), and with combind ulcer 297(9.7%). 3) We observed a peak incidence of peptic ulcer in the 50-69age group, gastric ulcer in the 5069age, duodenal ulcer in the 40-59age group. The ratio of male to female was 3.6 : 1 in peptic ulcer, 4.4 : 1 in gastric ulcer, 3.0 : 1 in duodenal ulcer. 4) The common site was angle in gastric ulcer, and bulb in duodenal ulcer. 5) The active stage was 39.4% of gastric ulcer, and 37.4% of duodenal ulcer, the healing stage was 34.2% of gastric ulcer, and 17.9% of duodenal ulcer, and the scar stage of gastric ulcer was 26.4%, and duodenal ulcer was 44.7%. 6) The size of ulcer was less than 1Cm in 66.7% of gastric ulcer, and in 75.5% of duodenal ulcer, the size of ulcer was greater than 2Cm in 13.2% of gastric ulcer, and in 6.5% of duodenal ulcer. 7) The frequency of multiple ulcer was 29.9% in gastric ulcer, and 16.5% in duodenal ulcer.

Clinical Impact of Hepatic Steatosis in Patients with Chronic Hepatitis B Infection on Tenofovir Therapy

( Jeong Eun Song ),( Young Eun Cheon ),( Hye Won Lee ),( Beom Kyung Kim ),( Seung Up Kim ),( Do Young Kim ),( Sang Hoon Ahn ),( Seong Gyu Hwang ),( Kwang-hyub Han ),( Jun Yong Park ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: To further observe and identify the effect of nonalcoholic fatty liver disease (NAFLD) on the response to tenofovir disoproxil fumarate (TDF) treatment in patients with chronic hepatitis B (CHB). Methods: From 2012-2014, consecutive antiviral-naïve CHB patients who started TDF and underwent controlled attenuated parameter (CAP) measurement were enrolled from two tertiary medical center. Based on CAP score, patients were divided into groups with NAFLD (CAP score ≥ 250) and non-NALFD (CAP score < 250). The demographic, anthropometric and clinical data was investigated at baseline, 24wk, 48wk, and 96wk. Results: A total of 159 patients (mean age 47.23±11.61 years, 90 (56.6%) males) were involved in the study, with overall percentages of NAFLD as 35.8% (n=57). The two groups were not significantly different in terms of age, sex, biochemical parameters and the status of compensated liver cirrhosis. Moreover, HBV DNA level and the status of HBeAg positive were equally distributed in both two groups. However, the NAFLD group showed a higher level of BMI compared with non-NAFLD group (p < 0.05). Although the HBV DNA undetectable rate increased gradually after treatment with TDF in both two groups, non-NAFLD group showed a higher virological response rate compared to NAFLD group (54.4% vs. 41.1%, 80.6% vs. 69.6%, 95% vs. 72.7%; week 24, week 48, week 96, respectively). However, there was significant difference between two groups only at week 96 (p<0.001). The rate of ALT normalization was higher in non-NAFLD group throughout the whole time spot, but reached no statistical significance. Multivariate analysis indicated that a higher HBV DNA level was associated with early virological non-response and that hepatic steatosis may influence long-term virological non-response. Conclusions: NAFLD significantly affected long-term virological response in CHB patients treated with TDF. Further investigation is needed in the future, which calls for a specific antiviral strategy in CHB patients with NAFLD.

Novel association between <i>CDKAL1</i> and cholesterol efflux capacity: Replication after GWAS-based discovery

Cheon, Eun Jeong,Cha, Do Hyeon,Cho, Sung Kweon,Noh, Hye-Min,Park, Sungha,Kang, Seok-Min,Gee, Heon Yung,Lee, Sang-Hak Elsevier 2018 Atherosclerosis Vol.273 No.-

<P><B>Abstract</B></P> <P><B>Background and aims</B></P> <P>Although the importance of the functional properties of high-density lipoprotein (HDL) has been increasingly emphasized, studies on the genetic factors associated with HDL function are highly limited. The aim of this study was to identify genetic variants associated with an individual's cholesterol efflux capacity (CEC) using a genome-wide association study approach.</P> <P><B>Methods</B></P> <P>This study included a discovery group of 607 subjects with coronary artery disease and an independent replication group of 158 subjects. CEC was assessed using a radioisotope and ApoB-depleted serum. Genome-wide associations between the adjusted CEC and genotyped and imputed variants were examined with linear regression, assuming an additive genetic model. Finally, adjustments were made for confounding parameters to assess the independence of associations and to determine R<SUP>2</SUP> of overall model on CEC.</P> <P><B>Results</B></P> <P>In the discovery group, 631 variants showed significant association with CEC, and five of them were found to correlate with CEC in the replication group. One of them was located near <I>LOC541471</I> in 2q13, whereas the other four (rs117835232, rs117252933, rs118064592, and rs150434350) were located in <I>CDKAL1</I> in 6p22.3. The association between the presence of any <I>CDKAL1</I> variant and CEC was significant after adjustment for clinical and laboratory variables. High-density lipoprotein-cholesterol levels also showed a very significant association with CEC. Body mass index, current alcohol use, triglycerides levels, low-density lipoprotein-cholesterol levels and statin use showed borderline associations with CEC.</P> <P><B>Conclusions</B></P> <P>We identified and replicated genetic variants associated with CEC using a genome-wide association study-based approach. <I>CDKAL1</I> variants showed correlations with CEC independent of HDL-cholesterol levels and other clinical characteristics.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We identified and replicated genetic variants associated with cholesterol efflux capacity (CEC). </LI> <LI> One variant was located near <I>LOC541471</I> on 2q13, and four were in <I>CDKAL1</I> on 6p22.3 </LI> <LI> The association between any <I>CDKAL1</I> variant and CEC was significant after adjustment. </LI> </UL> </P>